Biomedical subjects
Publications and source records attributed to Z Mariak.
Basing on literature and on an own case, the authors discuss the pathogenesis and treatment of aneurysmal cyst of the spine. Partial resection can be curative in some surgically inaccessible lesions.
A group of 41 patients were followed up 7 years after ligation of the common carotid artery. Postoperative complications were found in 29% of cases. Raised arterial blood pressure was noted in 66% of cases, psychoneurological abnormalities in one-third of the group.
Rheoencephalographic investigations (REG) was carried out in patients with intracranial aneurysms and in healthy subjects. The purpose of the study was to obtain approximate data on the efficiency of collateral circulation of the brain before ligation of the internal carotid artery. For this purpose REG was associated with common artery compression test. It was found that this combined examination gives good prediction of the efficiency of collateral circulation after ligation of one carotid artery. This method is more sensitive than the Matas test combined with EEG used previously.
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Rheoencephalographic (REG) investigations were performed in patients with ruptured intracranial aneurysms before and after common carotid artery ligation and in a group of healthy subjects. REG curves after ligation of the common carotid artery showed lowering of the amplitude of waves on the side of ligation and generalized vasospasm of varying intensity and different degree of penetration into the cerebral structures. These changes were more intensive on the side of ligation and persisted for over 2 weeks. REG is a valuable method for early diagnosis of vascular disturbances in acute postoperative period in these operations.
Clinical course of the case of a now 20 patient, with glioma of the optic nerve, removed 12 years ago, is presented. The tumour was removed with a intraorbital part of the optic nerve, but the eyeball was saved, what enabled the normal, symmetrical development of the child's face. Painful atrophy of the eyeball occurred 10 years after surgery and it seems that there will be a necessity to remove the eye.
The methods and results of histopathological and immunohistochemical investigation of an optic nerve tumour removed in a 6-year girl are presented. The difficulties were connected with a proper differential diagnosis between schwannoma and astrocytoma.
Modern intensive neurosurgical care is connected with the necessity of perception by the personnel of a great number of information from several monitored patients. This requires using sensors of various physical values and appropriate measuring and signalling systems. For avoiding of high costs connected with the use of specialized equipment, and for precise adjustment of the recording systems for specific use a PC-class computer with eight-channel chart of analog-digital transducer was used, together with a programme for collection, transduction and visualization of the recorder parameters. Both the transducer chart and the programme are in wide use although fully professional. The price is reasonable and the programme is fully intuitive. The association of computerized recorder with Polish pressure transducers made possible, among other, routine measurement of intracranial pressure in neurosurgical patients.
In the Ophthalmology Department, Medical Academy in Białystok control examinations of 17 patients aged 48-65 years were carried out late after ligation of the common carotid artery for intracranial aneurysm. The control group comprised 10 patients with such aneurysms not treated surgically. Using ophthalmodynamometry (Sobański method) reduction was found of the pressure in the central artery of the retina on the side of the ligated artery as compared to the contralateral eye and control group. Besides that, impairment of the visual functions was demonstrated in these cases, related probably to haemodynamic disturbances in the visual system following ligation of the common carotid artery.
It has been recently shown that small variations in cerebral temperature critically determine the extent of neurological damage following an ischaemic insult. These reports spurred a new interest in brain temperature among clinicians--neurologists and neurosurgeons. The information about this subject is very sparse and the mechanisms of cerebral metabolic heat dissipation are largely obscure. The author recapitulates the current knowledge of the problem and discusses the hypotheses relevant to human cerebral thermoregulation during normothermia and hyperthermia. Clinical relevance of these problems is also discussed.
The authors present a case of a 36 years old woman with systemic sclerosis and multiple cerebral aneurysms. A higher operative risk in patients with systemic diseases is discussed.
PURPOSE: Presentation of the results of secondary IOLs implantations in 35 aphakic patients operated on from January 1989 to June 1994 (in the years 1989-1994, first half). MATERIAL AND METHODS: Of 20 men and 15 women, in 17 patients cataract was removed by phacotomy, in 18-by intracapsular cryoextraction. Secondary anterior IOL implantation was performed 1 month--20 years after cataract surgery. The power of the lenses ranged from +17.0D to +23.5D and was calculated basing on the measurement of eyeball length and corneal refraction. RESULTS: Early complications found in 9 patients after surgery included: shallow anterior chamber in 2, anterior chamber haemorrhage in 1, iris "bombee" in 1, iritis in 1, united suteres in 2, corneal erosion in 1 and choroidal detachment in 1 eye. These symptoms declined one week after conservative treatment. In 2 patients, additional corneal suteres were inserted. One month after surgery, in all patients, visual acuity was 5/10-5/5. In 5 eyes, slight decentralisation of the pupil was observed.
Chordoma is one of rare intracranial neoplasms (0.2-0.5%). Apart from classic chordoma in 1973 r. Heffelfinger and al. separated chondroid chordoma which showed better prognosis. We studied 4 classic and 3 chondroid intracranial chordomas. All tumours contained chondroitine sulfate and keratan sulfate and showed positive immunohistochemical reactions to cytokeratin, S-100 protein and vimentin, supporting the concept of common origin of both types of chordomas. Immunohistochemical studies of PCNA and Ki-67 antigen and staining AgNOR's did not show significant differences in the proliferative activity between both types chordomas what attests to biological malignancy.